In gender and sexual minority health we’ve focused a lot on the bad things that happen to our communities. Studies about HIV risks, high rates of depression, and discrimination dominant the discussion. For good reason, too. Negative factors cause harm! We want to protect ourselves, our families, and our communities. Research helps us figure out how to stop the badness from happening. But not a lot of research has looked at gender and sexual minority wellbeing. After all, it’s not all doom and gloom. Many in the community are thriving. It would be helpful to know what helps those community members do so well. Today’s study looks at factors associated with wellbeing in transgender and gender non-conforming people.

First, let’s define wellbeing. Wellbeing can be difficult to define. It’s a two-fold concept, including both hedonic and eudemonic approaches. Hedonic wellness is experiencing happiness while avoiding pain. Eudemonic wellness is the sense that one has purpose in life and is living authentically.

Previous studies among lesbian, gay, and bisexual (LGB) communities found that LGB communities had less wellbeing than their heterosexual peers. Social and community support, education, and physical health are all associated with wellbeing. But we don’t know a lot about the transgender community’s wellbeing. At least, not in the literature.

So Stanton et al looked through published data from a large survey, the US Social Justice Sexuality Survey. This survey focused on LGBT people of color. In order to identify all the participants who might be trans, Stanton et al looked at data the participants who did not identify as cisgender.

This study assessed wellbeing by asking participants how often in the past week they felt:

Just as good as other people (eudemonic wellness)

Hopeful about the future (eudemonic wellness)

Happy (hedonic wellness)

That they enjoyed life (hedonic wellness)

In addition to those questions about wellbeing, Stanton et al specifically looked at factors they thought might be related, including: health, healthcare provider’s comfort with LGBT issues, family support, and connectedness and engagement with the LGBT community. And as with most other studies, they looked at demographic factors. Demographics included age, income, employment, marital status, and education.

Because OMH is a health-related blog, I’m going to focus in on the results most applicable to health. If you want to read the full study, scroll to the bottom to find a link to the paper!

What did they find?

402 individuals, about 8% of the broader study, did not identify as cisgender. Of those, 32% identified as trans women, 18% as trans men, 21% as men, 21% as women, and 35% as “other.” They were diverse, representing a broad range of ages, races, education levels, and health.

Most (71%) had health insurance. 85% felt their health was “good” or better. Just over half (57%) felt their health care provider was comfortable with their transgender status. 13% thought their health care provider was uncomfortable. 14% said their provider ignored their LGBT status. 16% stayed closeted with their provider.

63%, almost two-thirds, of the participants had high levels of wellbeing!

What factors were associated with wellbeing?

The following factors were associated with more wellbeing:

Feeling connected to the local LGBT community

Health

Family support

Heath care provider acceptance.

Education

Age: the older, the more wellbeing

These factors were not associated with wellbeing:

Having access to health insurance

Participation in the local LGBT community

Race

Employment

Being single

Income

One factor associated with less wellbeing was health care providers who were uncomfortable with or ignorant of their patient’s LGBT status.

What are the limitations of this study?

No study is perfect. The survey that this study pulled data from probably over represents individuals who are active in LGBT communities. Those individuals may not reflect everyone in the community. Health and health insurance levels may also have been higher in this study than in the broader population.

Most limiting is how some of the questions were worded. Gender identity and sexual orientation were mixed together by lumping questions on lesbian/gay/bisexual identity with transgender identity. And they are very, very different experiences. The communities are also different. Questions asking about “sexual identity” may refer to sexual orientation or gender identity or both. It would be good to repeat this study with clarification between sexual orientation and gender identity.

What does all this mean?

Two-thirds of this study’s non-cisgender participants had good wellbeing. Most trans people are doing well, unlike the popular narrative that trans people are broken. Let’s spread that message!

Also, by knowing who has better wellbeing knows we know who has worse wellbeing. We can direct resources toward those who need them! According to this study that would be the young, the less well educated, those without family support, and those who are less physically/psychologically healthy.

Lastly, this study highlights the need for health care providers who are accepting of minorities. Having a provider who knows and accepts GSM patients not only improves health care, it improves the wellbeing of the patient. We need to spread this message.

It’s good to know that it’s not all doom and gloom. Two-thirds of trans and gender nonconforming people are doing well. Let’s expand that number to 100%.

What is Open Minded Health?

OMH is dedicated to providing information about gender and sexual minority health. Posts are a mix of the latest research, activity risk reduction tips, and the latest news.

This blog is definitely not suitable for children, and probably not work safe. It contains descriptions of sexual activities that may disturb some readers.

Also please be aware: I am not a doctor. OMH does not provide health care advice - the information here is to be used as information only. It does not substitute a visit to your health care provider. When in doubt, please ask your health care provider.

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